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Introduction: Social networks have increased in recent decades, and with them the bullying, causing difficulties in young people's mental health expressed through depressive symptoms, suicidal ideation and suicide attempts. Up next, we present a case that exemplifies this situation., Objective: To describe a case report that exemplifies this new outlook in young people and how it affects their mental health., Methodology: Case report and non-systematic literature review., Results: One case report, treated at a hospital in Medellin due to two suicide attempts related to social networks is presented., Discussion: Currently, there are multiple social media resources, the advent of internet and smartphones is not only a strategy for improving social interactions, but it also contributes to impair mental health of some vulnerable young people., Conclusion: This case sensitize us, about the relationship between the growing social networking and cyberbullying as well as suicidal thoughts / attempts; thanks to this case and the available literature, we can't establish causality but we could deduce that the internet utter a increased risk for young people who are exposed and more vulnerable., (Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Background: In Colombia, one out of five women between the ages of 15 and 19 years have been pregnant. Almost two-thirds (64%) of these pregnancies were unplanned., Objectives: To examine the socio-demographic, psychosocial and clinical risk factors associated with adolescent pregnancy., Methods: An analytical prevalence study was performed using secondary data from the First Demographic Study of Mental Health in Medellin, Colombia. Female adolescents between 13 and 19 years of age were included in the study. The population was evaluated using the Composite International Diagnosis Interview, a structured interview developed by the World Health Organization, which establishes diagnoses according to the DSM-IV and ICD-10 criteria., Results: A sample of 499 female adolescents was obtained, in which 135 adolescent pregnancies were identified, representing a prevalence of 21.5%. The large majority (84.4%) were between 16 and 19 years old. The median age was 17 years, with an interquartile range of 2 years. Almost two-thirds (61.2%) of female adolescents had initiated sexual activity at the age of 15 or later. Almost one-third (31.9%) reported being physically abused during childhood, and 6.7% sexually abused. Of those who were pregnant, 66.7% reported previous sexual abuse. A bivariate analysis showed that sexual abuse (OR=7.68), childhood negligence (OR=4.33), and having a partner (OR=6.31) were factors associated with an adolescent pregnancy., Conclusions: Negligence and sexual abuse in childhood and adolescence can be prevented, and adolescent pregnancies can be decreased. This finding has important implications for clinical management and prognosis, and requires public preventive policies., (Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Introduction: Mental illness has been associated with violent behaviour. Criminal behavior in the mentally ill population in Colombia has not been well studied., Methods: This is a retrospective, descriptive study, from a secondary source. An analysis was made of the sociodemographic, clinical, and legal variables of 127 unfit to plead patients. A descriptive analysis of quantitative variables was performed by measures of central tendency, and frequencies and percentages were calculated for the qualitative variables. The software SPSS ® version 21.0 was used to analyse the data, and the study was approved by the Research Committee of the CES University., Results: The median age was 34 years, interquartile range 19 years, and 92.1% were men. The primary diagnosis was schizophrenia in 63%, 66.9% consumed alcohol, and 58.3% other drugs at the time they committed the crime. Almost one/third (29.1%) had a criminal record, and the most common type of crime was murder in 44.1% of cases. Around half (50.3%) of the victims had some degree of consanguinity with the patient., Discussion: The study subjects had higher illiteracy and lower educational levels than the Colombian prison population. Schizophrenia was the main diagnosis, and homicide the most prevalent crime, which agrees with the literature where non-indictable patients are responsible for 5%-20% of murder cases worldwide., Conclusions: To reduce the gap between the diagnosis and treatment of mental disorders, especially schizophrenia, should be within the specific actions to prevent violence and criminal behavior associated with mental illness., (Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Introduction: Delirium is the most prevalent neuropsychiatric syndrome in the general hospital. Its presence is a marker of poor prognosis for patients. Its prevention could be the most effective strategy for reducing its frequency and its complications., Objective: To review recent findings and strategies for the prevention of delirium., Methodology: A non-systematic review of scientific articles published in the last ten years in Spanish and English. A search was made in databases such as MEDLINE, Cochrane, EMBASE, Ovid, and ScienceDirect, for articles that included the terms, delirium and prevention., Results: Identification of predisposing and precipitating factors for delirium and a better understanding of the pathophysiological mechanisms underlying the onset of delirium have enabled the implementation of various pharmacological and non-pharmacological strategies in patients at high risk to develop hospital delirium. The studies to prevent delirium have focused on surgical patients. The current evidence supports the daily implementation of non-pharmacological measures to prevent delirium, as they are easy and cost effective. The available evidence is still limited to recommend the daily use of pharmacological strategies in delirium prophylaxis, and there is a consensus against the modest use of antipsychotic drugs in surgical patients and dexmedetomidine in patients in intensive care., Conclusions: New high-quality clinical trials and studies involving non-surgical patients are needed to provide more evidence about this subject., (Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Introduction: In order to address the mental health problems of the Colombian population it is necessary to have diagnostic tools (local and international) that are valid, easy to apply, and comparable., Objective: To compare the sensitivity and specificity between the CIDI 3.0 and the SCID-I for major depressive disorder, bipolar I and II disorder, and substance dependence disorder., Methodology: Cross-sectional study comparing the life prevalence of three mental disorders in 100 subjects using the CIDI 3.0 and the SCID-I. The study was approved by the Institutional Ethics Committee. The two diagnostic interviews were performed that measured by sensitivity, specificity, positive predictive value and negative predictive value with confidence intervals of 95%. The SPSS version 21.0 software was used for data analysis., Results: The median age was 43.5 years, with an interquartile interval of 30 years. The highest sensitivity (Se) and specificity (Sp) was observed for drug dependence diagnosis - with 80%, (95%CI, 34.94-100), and 98.46 (95%CI, 94.7-100), respectively., Conclusions: SCID-I and CIDI 3.0 showed different levels of sensitivity and specificity for the three disorders studied with: high for substance dependence disorder, moderate for bipolar disorder I and II, and low for major depressive disorder., (Copyright © 2015 Asociación Colombiana de Psiquiatría. All rights reserved.)

Background: Suicide is a public health problem. In Colombia, teenagers are considered a group at high risk for suicidal behavior., Objective: To explore the possible association between suicidal behavior and attention deficit hyperactivity disorder in adolescents of Medellin., Methodology: Observational, cross-sectional, analytical study. The Composite International Diagnostic Interview was applied to a total of 447 adolescents and the sociodemographic, clinical, familiar, and life event variables of interest were analyzed. The descriptive analysis of qualitative variables are presented as absolute values and frequencies, and the age was described with median [interquartile range]. A logistic regression model was constructed with explanatory variables that showed statistical association. Data were analyzed with SPSS® software version 21.0., Results: Of the total, 59.1% were female, and the median age was 16 [14-18] years. Suicidal behavior was presented in 31% of females and 23% of males. Attention deficit was present in 6.3% of adolescents. The logistic regression analysis showed that the variables that best explained the suicidal behavior of adolescents were: female sex, post-traumatic stress disorder, panic disorder, and cocaine use., Conclusions: The diagnosis and early intervention of attention deficit hyperactivity disorder in children may be a useful strategy in the prevention of suicidal behavior in adolescents., (Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Objective: To examine, from the point of view of a group of epidemiologists in training, their life experiences and work related to addressing mental health problems and mental health issues., Methods: An exploratory qualitative-descriptive study was conducted using ethnographic tools, non-participant observation, note-taking, and group interviews (FG)., Results: The participants mentioned that mental health and mental health issues are managed and poorly differentiated either by them and the community in general. They also said they were not ready to handle mental problems, or have the support of services for patient care, as mental health issues have not yet been clearly dimensioned by society. Epidemiology has its limitations, it focuses on knowledge of the physical-biological aspects and the use of quantitative approach with poor integration of the qualitative approach, thus hindering the understanding of a phenomenon that exceeds the limits of a research approach., Conclusions: This approach to issues of health and mental illness widens the view of knowledge from only a single focus. It includes an understanding of the qualitative approach as an option to advance the knowledge and recognition of a public health problem overshadowed by stigma and apathy of society., (Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

The term LTE (Limitations on Therapeutic Efforts) refers to the withholding or withdrawing of medical treatment to a patient (either with or without capacity to decide) who does not clinically benefit from it. Although some countries already have legislation and official documents to formalize it, there are several reasons limiting the dissemination and acceptance of this proposal. One is the fact that physicians and health institutions consider this issue as the sole responsibility of patients; another reason is that physicians and the community in general believe the discussion refers just to elderly and terminal patients. It is necessary an academic approach on LTE from both, physicians and the community in general, to promote a sound ethical reflection so as to assist patients and their relatives in the hard task of becoming autonomous to decide and plan their futures., (Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)